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EMDR and Acupuncture – Selling Non-specific Effects

The scientific approach to understanding the world includes the process of carefully separating out variables and effects. Experiments, in fact, are designed specifically to control for variables. This can be especially challenging in medicine, since the body is a complex and variable system and there are always numerous factors at play. We often characterize the many variables that can influence the outcome in a clinical study as “placebo effects” or “non-specific effect” – things other than a specific response to the treatment in question.

A common error to make when interpreting clinical studies is to confuse non-specific effects – those that result from the therapeutic interaction or the process of observation – with a specific effect from the treatment being studied. While this is broadly understood within the scientific medical community, it seems that within certain fields proponents are going out of their way to sell non-specific effects as if they were specific effects of the favored treatment.

This is perhaps most true for acupuncture. As has been discussed numerous times on SBM, the consensus of the best clinical studies on acupuncture show that there is no specific effect of sticking needles into acupuncture points. Choosing random points works just as well, as does poking the skin with toothpicks rather than penetrating the skin with a needle to elicit the alleged “de qi”.

The most parsimonious interpretation of the evidence is that the needles (i.e. acupuncture itself) are superfluous – any perceived benefit comes from the therapeutic interaction. This has been directly studied, and the evidence suggests that the way to maximize the subjective effects from the ritual of acupuncture is to enhance the interaction with the practitioner, and has nothing to do with the acupuncture itself. Acupuncture is a clear example of selling a specific procedure based entirely on non-specific effects from the therapeutic interaction – a good bedside manner and some hopeful encouragement.

This phenomenon is by no means limited to acupuncture. Perhaps another example is Eye Movement Desensitization and Reprocessing (EMDR), a practice that is increasingly popular among psychiatrists.

The concept of EMDR – how it is supposed to work – sounds pseudoscientific to this neurologist. According to the EMDR Institute:

During treatment various procedures and protocols are used to address the entire clinical picture. One of the procedural elements is “dual stimulation” using either bilateral eye movements, tones or taps. During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus. During that time, clients generally experience the emergence of insight, changes in memories, or new associations.

The external stimulus – whether moving the eyes or tapping on the client or playing certain tones – is supposed to help the brain reprocess memories and information, and is alleged to be useful for a wide range of psychiatric symptoms. The proposed mechanism sounds highly dubious. While the brain certainly has plasticity, the ability to change its wiring through use, it is hard to imagine how such a simple procedure could have a significant effect on this plasticity. There are many who suspect that the eye movement component to EMDR therapy may be the equivalent to the needle component of acupuncture.

In psychotherapy there are many sources of non-specific effects that would need to be carefully controlled for before the effects of any specific component can be determined. The interaction with the therapist, the time taken to focus on ones problems and symptoms, and the introduction of a novel element into the therapeutic relationship are all recognized factors. In addition, EMDR (not surprisingly) has evolved into a multifaceted treatment approach, that includes many standard elements of therapy. This always reminds me of the commercials who proudly advertise that their products are “part of this nutritious breakfast.” Yes, but are they an important part – or is the breakfast nutritious without it?

A 2002 review of EMDR in general concluded:

Current component analyses of EMDR have failed to effectively evaluate the relative weighting of its procedures.

And a more recent 2006 review of EMDR compared to cognitive-behavioral therapy for post traumatic stress disorder (PTSD) concluded:

Our results suggest that in the treatment of PTSD, both therapy methods tend to be equally efficacious. We suggest that future research should not restrict its focus to the efficacy, effectiveness and efficiency of these therapy methods but should also attempt to establish which trauma patients are more likely to benefit from one method or the other. What remains unclear is the contribution of the eye movement component in EMDR to treatment outcome.

The last line is most significant – what contribution, if any, does the actual EMDR have? The research has not clearly established that the eye movements are having a specific neurological or psychological effect. Perhaps it’s just all the other components of the therapy that is having the perceived effect. And yet EMDR has been widely accepted as a treatment modality. This acceptance seems premature.

It also seems that this is another failure of the evidence-based medicine (EBM) approach – EMDR  is being hailed as an evidence-based practice. There are indeed studies that show that EMDR therapy works. But a science-based approach would consider more deeply the question of plausibility and mechanism, and from this question whether or not EMDR has indeed been established as having specific efficacy.

Conclusion

EMDR, like acupuncture, is likely nothing more than a ritual that elicits non-specific therapeutic effects.  While there are some who may consider this a justification for both modalities, there is significant risk to this approach. First, the non-specific effects are often used to justify alleged specific mechanisms of action which are likely not true. This sends scientific thought and research off on a wild-goose chase, looking for effects that do not exist. Science is a cumulative process built on consilience – scientific knowledge must all hang together. These false leads are a wrench in the mechanics of science.

Second, the false specificity of these treatments is a massive clinical distraction. Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work.

And in the end these magical elements do not add efficacy. For example, as the review above indicates, EMDR is no more effective than standard cognitive-behavioral therapy.

Rather than getting distracted by alluring rituals and elaborate pseudoscientific explanations for how they work, we should focus on maximizing the non-specific elements of the therapeutic interaction, and adding that to physiological or psychological interventions that have specific efficacy.

Posted in: Acupuncture, Clinical Trials, Neuroscience/Mental Health

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49 thoughts on “EMDR and Acupuncture – Selling Non-specific Effects

  1. Jan Willem Nienhuys says:

    One explanation of EMDR might be that it works by letting people think a bit about what bothers them, and before they can think too much, interrupt them with any kind of gimmick, a simple task, no matter what. In this way the impact of the imaginary exposure is decreased. The nature of the interruption (watching a moving finger, tapping on the knee, being asked to rate your own feelings, ask the subject to stare at a point or tap with the finger, let the patient write something, instruct the patient to relax, or focus on any small task that demands full attention) isn’t important.

    It must be difficult to test this properly.

  2. windriven says:

    “There are indeed studies that show that EMDR therapy works. ”

    Could you cite some of these studies, please? It all boils down to the response rate. Multiple studies showing a marked response to EMDR would suggest the need for more careful study while tepid responses suggest ‘move along, nothing to see here.’

  3. windriven – the reviews that I read, including the one I linked to above, show that the magnitude of effect is about the same as standard therapy, like CBT. I think this is because EMDR is just CBT with a gimmick thrown in (that’s the “integrative” approach of EMDR.)

  4. windriven says:

    Dr. Novella – It wasn’t clear that the Journal of Clinical Psychology review looked at ‘integrative’ EMDR. I didn’t access the entire article, only the abstract.

  5. Harriet Hall says:

    I met a psychologist who uses EMDR. He thinks it is a useful gimmick to get the patient’s attention and motivate him to cooperate with CBT.

    Maybe, but I could only condone that if it were presented without any lying about how it works. More like “Let’s play a game that might help you engage with the treatment.”

  6. BlandOstrich says:

    Could EMDR’s effectiveness relate somehow to the unconscious thought effect? I am absolutely no expert on any of this, but it seems like the two things might be related. If that were the case, eye movements and such could be considered specific-ish, no? At least in the sense that just hanging out with the person administering the EMDR might not be sufficient to see the effect.

  7. GLaDOS says:

    One explanation of EMDR might be that it works by letting people think a bit about what bothers them, and before they can think too much, interrupt them with any kind of gimmick…

    Not just interruption but obedience. EMDR is a modified Scientology “TR” or training routine. Following directions mindlessly can be comforting and relaxing.

    Video: http://www.youtube.com/watch?v=e7xiY54d96M

    If you don’t want to watch all 24 minutes, start 16 minutes in. “Do birds fly?” is my favorite TR for some reason.

    EMDR was the first cottage therapy –the first intervention to arise apart from the rough-and-tumble of a University setting where ideas are shared and criticized without trademark or copyright barriers. Now there are several businesses selling e-learning certifications in “mental health first aid,” “trauma informed response,” “psychotherapeutic counseling,” “intuitive healing,” and “life coaching.”

    If you think Oprah stupified America by making magical thinking seem trendy and upper class, just wait for the hoards of e-shrinks about to send us on long treks in search of mystery sandwiches buried deep within our childhoods and past lives.

  8. ebohlman says:

    My (lay) understanding is that EMDR is basically exposure therapy (a well-studied, documented-effective form of behavior therapy) with some mystical trappings added. Therefore, it would be expected to be as effective as exposure therapy. The problem is that exposure therapy is less expensive and far more practitioners can do it.

    GLaDOS: I like to talk about “open source” and “closed source” therapies, the latter being what you call “cottage therapies”.

  9. klox says:

    Any idea when foot massages will be absorbed into mainstream doctor visits to up that therapeutic interaction? Can’t wait! ;)

  10. pmoran says:

    Rather than getting distracted by alluring rituals and elaborate pseudoscientific explanations for how they work, we should focus on maximizing the non-specific elements of the therapeutic interaction, and adding that to physiological or psychological interventions that have specific efficacy.

    Oh, I agree. That would be good. However, CAM is probably in part a reflection of our ability to do that successfully under present conditions and with our present range of EBM-endorsed methods.

    For example –

    Most doctors work under considerable time constraints.

    The trusted long-term family doctor as the dominant medical option is not so in evidence these days. It is more difficult for doctors to establish the same kind of relationship with patients.

    EBM/SBM places severe limitations on our therapeutic options excludings ones that our patients and some doctors may wish to try first in preference to ones with better established specific efficacy but serious side effects.

    Some treatment programs e.g. acupuncture, provide a structure for ongoing non-specific interactions that would be otherwise difficult to sustain.

    It requires a subtleties and skills that not all doctors possess and that are not easily taught..

    It is not clear how doctors can sustain non-specific interactions when treatments with specific efficacy have been exhausted, or whether they can be as effective without at least symbolic “treatment”. Our evidence all relates to non-specific effects working alongside sham treatment.

    So far as getting distracted by ” — alluring rituals and elaborate pseudoscientific explanations — ” this is MY point — every debunking dignifies this crap to some small extent. Our time and energies might better be devoted to trying to work out what best do about it, while also preserving optimal patient outcomes.

    That will be messy. It inevitably involves conflicting impulses, so it is as much trying to understand ourselves and our own medicine as understanding CAM.

  11. GLaDOS says:

    pmoran, how ’bout we leave the bullshit to some other profession that is not the one I happen to be in?

    I mean, I can get my car repaired without mysticism. So why do I need a doctor AND a mystic rolled into one?

    I have a hard enough time keeping straight what is actually true, more or less, about this world we share. If I must also keep straight the delusions of my colleagues, I’m doomed.

  12. Shelley says:

    @ebohlman, my sense is that this is exactly correct. It has been several years, but my recollection is that EMDR was first introduced as a treatment for PTSD for which Exposure is a primary treatment modality.

    EMDR then went on to be used for nearly every mental health issue around. Its appeal for therapists is obvious — minimal training required and you get to add a new technique to your CV!

    Back around 2002 I went to a training session for EMDR. As a grad student we’d conducted an exercise in critiquing the limited literature and I was curious as to what would be said by those selling it.

    I asked the instructor exactly what the mechanism was that made the finger movement work. He informed me that you didn’t need finger movement; you could also tap a pencil, let the patient tap, or any number of other things. (Note the evasion of the question.)

    I then suggested that if that was the case, perhaps you didn’t need the tapping at all, and he replied, “No, that’s the great thing about EMDR, it is so flexible, you could probably get the benefit without it.”

    In essence (as someone much smarter has said):

    “What WORKS about EMDR isn’t new (mere exposure and therapeutic alliance) and what’s NEW about EMDR (tapping etc) doesn’t work!”

  13. pmoran – I agree that there may be room in the health care system for providers whose main goal is lifestyle counseling, relaxation, encouragement, and maximizing the therapeutic interaction. This does not have to be either a busy and overqualified doctor or a mystic. It could be an allied health professional, such as a nurse or counselor, who is strictly science-based but whose time, training, and talents are geared toward this intervention.

    There is already a model for this. Many doctors use nurses or LPN’s or equivalent as extenders for patient education. Physical therapists can serve this role with respect to musculoskeletal problems, and counselors/psychologists/social workers for psychiatric problems (working with psychiatrists or by themselves).

    Perhaps this role can evolve out of an existing health profession – probably a nurse extender makes the most sense. There could be special training and certification for this. The key will be getting reimbursement – if the insurance companies pay for it, it will spring into existence overnight. Then the trick is making sure it is science-based, and not just another avenue for woo.

  14. Solandra says:

    I reposted the past two articles on Acupuncture on my Facebook, and you wouldn’t believe the responses I got. One person unfriended me. People look at this stuff like a religion, and it’s going to be hard to convince someone who believes in Chi and energy and such that this doesn’t work. What’s a skeptic to do??

  15. GLaDOS says:

    The New Agers say it and claim it and make covenants to strengthen their creative intentions.

    The Christian flavored New Agers quote the Bible verses about “two or more of you” agreeing in prayer to make something happen.

    The Scientologists define spirit or “theta” as “Affinity Reality Communication” or “ARC,” which is a more complicated way of saying that reality rests upon intentional agreement.

    Ergo, it really is impossible for New Agers to remain in communication with critics. They view persistent critics as suppressive persons or “SPs” and teach that failure and illness result from ongoing contact with SPs.

    This positive thinking clap trap including the bits about recognizing and handling suppresives is hinted at in materials from the HR dept where I work. Now that I’m aware of it I notice that it’s also prevalent among many with business degrees.

    I’m worried the New Thought has become so normalized that it cannot be seen let alone stopped. I see it because I’m old enough to remember the other Jesus –the one that made you feel bad about yourself because you weren’t thinking of the poor as often as you should. This new one, the make-a-wish warrior Christ, he’s just not the same.

  16. CLK says:

    Did you come across any studies looking at EMDR and kids? My only interaction with this has been children’s trauma centers that do EMDR therapy with kids around singular traumatic events when the kids aren’t old enough for talk therapy or even play therapy.

  17. GLaDOS says:

    Trauma therapy for children is a very bad idea, IMHO.

  18. GLaDOS says:

    Oh I should probably clarify. A kid with post-traumatic symptoms can benefit from a course of psychotherapy. But the focus should be upon everything important in living apart from the trauma. Trauma 10%; everything else 90%.

  19. GLaDOS says:

    Actually trauma 2%; everything else 98%.

    Trauma is dissociation. The more the brain dissociates, the more it dissociates.

  20. evilrobotxoxo says:

    I think it’s unfair to compare EMDR to acupuncture. Acupuncture is a fake treatment, while EMDR is a real treatment (exposure) with a fake treatment attached. And I’m not even sure that one can say that the distraction plays no role. one of the big problems with exposure treatments for anxiety disorders is low compliance with the treatment, including people freaking out during the exposure, which can make their anxiety worse. People who do cbt for PTSD typically teach the pt relaxation techniques before doing the exposure, to help prevent this. I suspect that EMDR is just a nonspecific distraction technique to help the pt tolerate the exposure treatment. Steve’s right that their postulated mechanism is undoubtedly bs, but I dont think that the claim that the addition of a distractor task to exposure treatment is fundamentally implausible, even though it’s also true that the EMDR advocates have not convincingly demonstrated it.

  21. CLK says:

    GLaDOS, I have to say I don’t understand. How can psychotherapy help a pre- verbal child, or even an 8 year old? It isn’t recommended for this age group from what I have researched. I am also unclear about what you mean when you say focus on everything that isn’t trauma, or that trauma is dissociation. Dissociation is certainly a symptom of trauma for some individuals, but it is not the only feature.

    I had a friend, probably 12 years ago who had a scary incident where a mental patient came in through her back door and became violent threatening her and demanding her newborn she was holding. Her two year old witnessed the entire thing, and it ended well fortunately.
    The two year old had tremendous sleep disturbance, very clingy and stranger avoidant etc… She brought him to a child and family therapy center and because of the age of her son, they explained that the only therapy they could offer was EMDR, and that they were having good success with it reducing trauma symptoms in a population with singular traumatic events. She decided to go for it, and her childs sleep and behavioral issues ceased. Not a conclusive study I recognize, but her experience was apparently consistent with others.
    So is the child experiencing the placebo effect? Is it another aspect of the therapy- the telling of the story itself, the focus and attention on the child that is really helping?
    My litmus test for whether something is or is not placebo is whether it works with infants or kids. Maybe I need to reconsider that.

  22. GLaDOS says:

    CLK what you describe is a Scientology TR called a “locational.” EMDR also involves talking about the traumatic experience while complying with the command to visually follow the coach’s finger.

    If staring at someone’s finger as they move it about is enough to fix PTSD, that really is quite amazing.

  23. daedalus2u says:

    CLK, placebos do work on children. The archetypal placebo is a mother’s “kiss it and make it better”. Children need such experiences because they need to train their ANS to be coupled to their CNS so they can “turn off” the fight or flight state when the need for such a thing is over.

    A placebo is a treatment that works, but not through pharmacology or surgery or something else physical. Psychotherapy is a placebo under my definition. It is a placebo because it doesn’t work through pharmacology, surgery or something else physical. It works through communication and through the relationship between the patient and the therapist.

    What you need to fix PTSD is a high NO level and then time in a safe environment to allow neuronal remodeling to switch neuroanatomy to a non-PTSD state.

    I see PTSD as a “feature”, to facilitate survival while living in a war zone, hypervigilance so “they” can’t creep up on you, insomnia so “they” can’t get you while you are asleep, hair trigger temper so you attack before “they” attack you, flat affect so “they” can’t figure out your weaknesses, rapid escalation to violence so you get them before “they” get you, hair triggering of the fight or flight state so you are ready to fight before “they” are, dissociation so you can do what you need to do to “them” without feeling guilty.

  24. Cloudshoveller says:

    My experience with EMDR in Canada has been very different from what the previous posters have been describing.

    In Canada the scientific foundation is the rapid movement of eyes one experiences when undergoing trauma or heightened emotion. EMDR tapping is designed to “mimic” that eye movement and gain access to the emotion of that time.

    There is no following the finger of the practicioner and the client never does the tapping themself.

    This is not something that can be learnt in a couple of “fly by night” courses. I concur that it would be helpful to have a standard of teaching and certification.

    A qualified EMDR practicioner would only start this process with a client where there is a mutual trust built up.

    I sense the reluctance of many to acknowledge this as a legitimage practice. However, I think it would be unwise to completely dismiss something that has been found equally effective as cognitive therapy.

    EMDR is not for all people or all situations, but it can be a tool for the mental good.

  25. Jan Willem Nienhuys says:

    Is watching a tennis match good for your mental health?

  26. Harriet Hall says:

    @cloudshoveller,

    “the scientific foundation is the rapid movement of eyes one experiences when undergoing trauma or heightened emotion.” That’s news to me! Please substantiate with references.

    “it would be unwise to completely dismiss something that has been found equally effective as cognitive therapy.” It has not been found equally effective. It has been found that psychotherapy using the EMDR gimmick is comparable to psychotherapy alone.

  27. Harriet Hall on effectiveness (or is that efficacy?): “It has been found that psychotherapy using the EMDR gimmick is comparable to psychotherapy alone.”

    Apparently there are people who like the EMDR gimmick. Is it possible that there are some people who prefer their CBT straight up, and others who like it with mixer?

    Rum & coke and neat rum will both get you drunk, and both conditional on the amount of rum (not coke). However, a young person trying to get really drunk for the first time might have better success using a mixer.

    Is there a reason not to sell a non-specific effect, if people like it? Very few people consider that it’s unethical of bars to carry mixers, though if their goal is to get drunk they may be very concerned about the alcohol/mixer ratio.

  28. Harriet Hall says:

    Alison,

    OK, offer it as a game that might subjectively make the treatment more palatable. Just don’t tell the patient the eye movements have some objective effect. I’m all for nonspecific effects; I’m just against lying about them.

  29. GLaDOS says:

    Alison, there’s too much overlap between “I like this” verses “I feel better.”

    Anyway, the content of EMDR is beside the point. See above where it’s following a finger, then having spontaneous eye movements, then “tapping.” Are you catching on?

    The entire EMDR business model is an agenda-driven (psychs are bad!) end run around peer review. 100% evil. Should have been nipped in the bud when it appeared to avoid setting a precedent.

  30. GLaDOS,

    Yeah, I’m not cool with end-runs around peer review, or if EMDR is practiced by non-psychologists. (Clinical psychology is really hard. I know that because most of the ones I’ve seen practiced it very badly. Not good for someone clueless to be messing around with someone else’s brain.) (Psychs are bad, but … well, I dunno. The psychs I saw with the least training didn’t help, but they didn’t damage me either. It’s been the ones with the best training who were able to do the most harm. They are also the only ones who have been able to help, but the ones who helped and the ones who harmed were not the same ones.)

    I am totally cool with “Hm, we aren’t making a lot of progress like this. Ok, let’s do it again but this time follow my finger…” I’m not sure that would even require more than anecdote to try ethically.

    Note that for some psych issues, “feeling better” is the only point.

  31. GLaDOS says:

    Psychs are bad, but … well, I dunno. The psychs I saw with the least training didn’t help, but they didn’t damage me either.

    You’re not in the same ballpark with the “bad” in question.

    The psychiatrists caused the holocaust.

    They also are responsible for 9/11.

    They are the aberration casting a dark spell across planet earth.

  32. Robert S. says:

    GLaDOS, What’s with the scientology poe routine? We get it, scientology uses known, destructive, behavioral modification and conditioning techniques. It is the perversion of psychology that it claims is practiced by psychiatrists.

  33. Robert S.,

    I actually think it’s useful to know where anti-scientific ideas are coming from. Are they deliberately being pushed into the mainstream under camouflage? Are they the imaginings of naive people with little direct experience? Are they the strenuous objections of people who feel that they have done everything right according to the conventional rules and have been poorly served and badly treated?

    Depending on where the ideas are coming from, countering them will require different strategies.

    If a cult-themed business is actively trying to promote its ideas, I want to know. A little like I want to know if a “smokers’s rights” group is actually a front for a tobacco company. Unmasking them should go a long way towards reducing their credibility.

    I didn’t know that Scientology was promoting EMDR as an alternative to clinical psychology. (If that’s what you’re saying, GLaDOS?)

  34. GLaDOS says:

    Robert S.,

    All the naturopathic colleges in the UK are run by Scientologists, who have a strong presence at the naturopathic programs in the US apart from the one in Bridgeport CT which is run by Moonies.

    The Scientologists sell practice management systems to many chiropractors. The Society of Chiropractic Management Consultants (SCMC) is run by Scientologists.

    The major alternative medicine celebrities –Kevin Trudeau, Holoford, Mercola, and Mike Adams– are allies of the CCHR. Although Mercola is not a Scientologist, his teachings are consistent with LRH tech in which everything wrong with you is largely due to toxins or trauma. His promotion of the New German Medicine would warm Hubbard’s heart.

    tl;dr: OSA monitors and selectively participates in organized political efforts against science based medicine in the US.

  35. GLaDOS says:

    Alison, EMDR is a Scientology spin-off. It’s an elaborated locational assist, essentially. Many people offering Dianetics auditing also offer EMDR, life coaching, hypnosis, etc.

    But most people who decide to spend the $2000 or whatever they’re charging these days for an EMDR certification have no idea about the Scientology connections, just as most police who get involved with the Drug Free Marshalls have no idea they’re forwarding a Scientology agenda.

  36. Jan Willem Nienhuys says:

    I don’t know about the USA nowadays, but EMDR was thought up by Francine Shapiro (see http://en.wikipedia.org/wiki/Francine_Shapiro ) and in 1996 it was seriously criticised by Scott Lilienfeld, his article is now on Quackwatch:

    http://www.quackwatch.org/01QuackeryRelatedTopics/emdr.html

    Lilienfeld hasn’t changed his views, see http://www.scientificamerican.com/article.cfm?id=emdr-taking-a-closer-look

    In all the criticism of EMDR I haven’t seen anything about a Scientology connection. The only similarity seems that founders of both liked impressive sounding buzz-words like processing.

    It seems that there are now about 60,000 people trained as EMDR therapists. If there was a clear link, then some people would have discovered that, I’d say.

  37. JRS says:

    I found EMDR to be very helpful in dealing with a prior traumatic experience that I was going to have to “re-live” – as in face similar circumstances. I was seeing a psychologist, and all the talking was nice, and somewhat helpful, but not as helpful as I’d hoped. She suggested trying EMDR. I was skeptical but figured it couldn’t hurt.

    It was actually very helpful – really, the sole effect of the eye movement was something to distract me from overanalyzing my own feelings and thoughts constantly, so that I actually did focus on the traumatic memories more effectively. The end result was that the process was useful in identifying why those specific memories were traumatic, which was then very helpful in determining what I could do to make the soon-to-be re-visiting of those circumstances less traumatic and anxiety-producing. Also, where I previously always had at least some low level of panic when recalling the two or three specific memories we examined using EMDR, after the EMDR and discussion I was surprised and pleased that the automatic fear response was gone. It’s still gone, about a year later.

    I think Jan describes the effect/mechanism of EMDR properly. By distracting me (conscious, analytical, controlled me) with a task requiring a small amount of concentration and physical effort, and then encouraging essentially free association from the upsetting memory, it brought down the self-protective barrier around the memory and provided a more effective way to examine the memory and the root of the emotional issues/trauma associated with the memory. It was more helpful than our prior conversations along the lines of “What about that incident do you find upsetting?”

    I don’t think there’s anything special about the “eye movement” part of it – yes, it works for its specific purpose, but I would think you could probably do a number of different things that would provoke the same response in the patient. The psychologist I was seeing didn’t “sell” the treatment in any way or laud the eye movement as the key to the therapy, and didn’t disagree with me when I described the physical distraction of eye movement as helpful (suggesting any sort of similar distraction would probably work). And although I was skeptical of EMDR, I was ultimately happy with the results and felt it was a helpful tool for the psychologist to have (not the only tool, of course, just one of many things, each of which will probably suit some patients better than others).

    I didn’t pay anything extra for EMDR. It was just something the psychologist offered as an option, and I figured it was worth a try. Out of many sessions over months, we used EMDR in only two or three sessions.

  38. GLaDOS says:

    It seems that there are now about 60,000 people trained as EMDR therapists. If there was a clear link, then some people would have discovered that, I’d say.

    LOL that’s $120,000,000 for just the certificate alone. Suckers.

    I’m not the first to see how EMDR rips off Dianetics. Here’s a quote from a review of an EMDR book at Amazon.com:

    The key appears to be that bilateral work–as in Applied Kinesiology’s “cross-patterning” and “cross-crawling” tends to recruit and integrate the two cerebral hemispheres, so as to expedite the higher brain’s accessing of lower brain centers in the limbic system, so as to allow reprocessing of traumatic material which has been just setting there, like an undigested meal in the stomach, poisoning the client’s life. I will add that I have found psych. “tapping” to dovetail nicely with EMDR technique. These tools work so well, that their operation may seem nothing short of miraculous to many. At least for some psych. problems, they work more rapidly than ordinary “talking therapy,” and much more rapidly and effectively than psychoanalysis.

    A criticism is that–as far as I can tell–no one in this book credits the work done by Dr. Jung. The Jungian complex is essentially the same as the PTSD phenomenon, which is discussed extensively throughout this book. And, no credit is allowed L.R. Hubbard. The scientology engram is also essentially identical to the PTSD phenomenon, and much good work has been done by those who dub themselves scientologists, rather than psychologists. There are elements of Dianetics and Scientology which are very similar what one finds in EMDR.

    Applied kinesiology is like the e-meter for people who don’t like Scientology. The chiros love it.

    This bit right here: “These tools work so well, that their operation may seem nothing short of miraculous to many.”

    OMG no one writes copy like that apart from mah friends at the Adventure Club.

  39. CLK says:

    GLaDOS, this is sounding like a conspiracy- on the level with the Masons or something. Is it possible that Scientology isn’t all that unique and smart, so many people can simultaneously think up the same woo at the same time? Or do you think this is a widespread movement infiltrating all kinds of seemingly benign areas of our lives? I mean, I’m getting chills these days just hearing the word “scientology” with everything I come across, but sometimes I wonder if this isn’t a rehash of other overblown conspiracies.

    On another note, having not experienced EMDR personally, I requested a session with my current therapist to satisfy my curiosity. Interestingly, of my options for therapists which numbered 15, 8 offered and advertised EMDR and most were trained “psychoanalytically” in well known programs, 5 were PsyD’s, and 2 psychiatrists also advertised EMDR. I had assumed, because of how ubiquitous it is, and my earlier experience with it for a child, that it was a research based augmentation to therapy. I have even suggested clients look into it as an option based on this assumption. Thanks for raising the question.

  40. GLaDOS says:

    There is a conspiracy, but it’s only a component of the alt med problem. If humans weren’t so invested in the ideas the snake oil salesmen promote –e.g., if you eat right you won’t get sick– the bad guys wouldn’t get very far.

    Wikipedia on some of the covert ops the Feds have proven in court here.

  41. GLaDOS says:

    CLK, I apologize for my psychiatric colleagues. They are nice people, people pleasers, and they’ve jumped on the alt med bandwagon along with the rest of America. I like and respect most of them, just not as critical thinkers.

    But as has been said before, most doctors in the clinic are not scientists. They rely upon the academic centers to get the facts straight for them. That’s why quackademic medicine is such a very bad thing.

  42. Jan Willem Nienhuys says:

    GLaDOS wrote:

    I’m not the first to see how EMDR rips off Dianetics. Here’s a quote from a review of an EMDR book at Amazon.com:

    The reviewer, ‘Sam Clemens’, wrote more reviews. He is enthousiastic about Duesberg and the ‘AIDS’-hoax, he writes a ‘review’ about he book he doesn’t like (the book seems to say the Oswald did it), and he reviews several conspirationist books, and is an admirer of Wilhelm Reich (“Our fascistic, illegal and unconstitutional policies (and Nazi-like propaganda campaigns) in recent years…”) and his enthousiasm about chiropractic results in observations like: “Many today do not realize that chiropractic is based on solid neurological principles, research and clinical practice.”

    Such a person would probably also believe in the evil conspiracy of all psychiatrists as sketched by those virtuous Scientologists.

    For now, I think that if this person says something, it is almost guaranteed to be nonsense. If you want to prove the scientology has something to do with EMDR you’ll have to do better than produce an obvious conspirationist cum sCAM-fan with a pseudonym as witness.

  43. GLaDOS says:

    Well derp yeah the reviewer is a Scientologist. Those guys love EMDR for a reason.

    The “modern science of mental health” aka Dianetics is all about traumatic memories filling the “bank” or “reactive mind.” Going “clear” means removing the “charge” from those memories through auditing. When a traumatic memory is “re-stimulated,” a person “dramatizes” some memory. They can be “brought up to present time” using assists. A “locational assist” is an instruction to the pre-clear to look at something in the environment in the here-and-now. Doesn’t really matter what it is. “Look at that wall… look at that coffee cup… look at my finger.”

    The idea is to disrupt the pre-clear’s sense of being stuck in the prior incident by re-orienting him to present conditions.

    The only thing I see different about EMDR verses locationals is the added layer of pseudoscience speculation about brain re-wiring that comes with EMDR.

    Hubbard wrote all this crap out in the 1950s, so yeah, I think those EMDR guys need to give credit where it’s due.

  44. Jan Willem Nienhuys says:

    Francine Shapiro was barely two years old when Hubbard published his amateurish pop-psychoanalysis in Astounding Science Fiction. Initially Dianetics was quite a success, so there is no way to exclude that Shapiro somehow picked up a few ideas between 1948 and 1987. Psychoanalysis with its emphasis on having to relive and remember unpleasant experiences also existed all the time.

    Beyond a vague similarity (EMDR aims at removing real remembered traumas, while in Dianetics the traumatizing events have to be invented during therapy, e.g. prenatal engrams caused by your pregnant mother having a quarrel or trying to abort you; in Dianetics this invention process is even the most important part) there is no connection. There have been shown no scientologists practising EMDR, or scientology organisations teaching it (unlike what they do as Narconon) or EMDR money flowing into scientology coffers or conversion of EMDR patients into Scientology.

    One silly guy trying to annex it, is not enough. That’s what pseudoscientists regularly do: they see something vaguely resembling (in their eyes) their own pet idea, and then they say they have invented it. It’s a variant of imitating the language of real science (quantum mechanics, relativity, electromagnetism, DNA) and then twisting it in their own direction.

    There are enough people extremely critical of Scientology, so if there was any connection, I think it would be better known.

    I think it would be in the spirit of SBM not to play homeopath and take any similarity for a real connection.

    Incidentally, I can’t find this explanation of a locational assist in my copy of Dianetics. One would expect it in Ch. 9 of Book 3, but I can’t find it. Of course, it is elsewhere in Scientology, but in Dianetics?

  45. epersonae says:

    I had a very similar experience to JRS’s, about 5 years ago with a therapist who I was seeing for depression. I think we only tried it once, and it struck me as a interesting change of pace in a phase where I was having trouble getting over some hurdles. (I really liked her, but the therapist I saw after that one retired was the one who’s probably helped me the most…with pretty straightforward CBT.)

  46. GLaDOS says:

    Reviewing upsetting experiences is common to all talking therapies. The bit that is special to EMDR is having the client direct their gaze at something while re-experiencing emotions associated with the painful memory. That’s the bit that is just like a locational in Scientology.

    When Volunteer Ministers rush to disaster areas they do “touch assists” on people. They touch people and say, “feel my finger,” or something like that. The idea is to bring the upset thetan up to present time and place.

    Same thing with locationals. In Scientology, thetans get stuck in the past due to trauma. By directing awareness at something in the here-and-now the thetan learns to move on.

    So there you go. To me EMDR looks like a locational. Same cartoonish “traumatology” model of human mental disorders.

  47. GLaDOS says:

    Here’s a Wikipedia article on the “power therapies” –EMDR, TFT, EFT, VK/D, and TIR. They are all examples of “assists” and are popular among the New Age or Holistic therapists.

    http://en.wikipedia.org/wiki/Power_therapies

    I’m not claiming a corporate link between Scientology Inc and EMDR Inc. I’m saying that EMDR rests upon a “traumatology” model of mental illness identical with Scientology. I’ve not researched the basis for this link, but might look into it later if I have time.

    I’m guessing Scientologist and psychiatrist Frank Gerbode, promoter of TIR, might be involved.

  48. CLK says:

    “feel my finger,”
    My dad used a similar technique when I was a kid to interrupt my focus from being hurt or emotionally distraught, only he would say “pull my finger”. You all know the rest…

    So did scientology invent trauma theory or treatment paradigms? Or did they co- opt it in your opinion? Is there any research proven treatment for PTSD besides exposure therapy?

  49. GLaDOS says:

    Hubbard stole pretty much all his ideas from others.

    PTSD is a continuum overlapping with other disorders involving dissociation and identity instability.

    Almost nobody gets better until the litigation and/or service connected disability issues are settled.

    We need moar science, not more agenda-driven trademarked promises.

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